Modified Mohs surgery is a procedure which eliminated chemical fixation step from Mohs chemosurgery. This technique is faster, less painful and more tissue conserving, allows for immediste repairs, yields higher quality histologic preparations and facilitates an interdisciplinary apporoach; it is the treatment of choice for recurrent or difficult skin cancers. A 58-year-old femele patient presented with a 2x 3cm sized dark brownish, ulcerated nodule on the left upper eyelid. Histopathologic findings revealed several small solid nest composed of basalioma cells in the dermis. We treated with modified Mohs surgery and obtained good result.
Carcinoma, Basal Cell* ; Dermis ; Eyelids ; Humans ; Middle Aged ; Mohs Surgery* ; Skin Neoplasms ; Ulcer

No abstract available.

BACKGROUND: The purpose of this article was to identify the risk factors related to development of hemodynamically significant cardiac arrythmias in patients with mechanical ventilation. METHODS AND RESULTS: Holter recording and echocardiogram were performed after 30 minutes of ventilator initiation in patients on mechanical ventilation(MV) owing to respiratory failure(RF) from various reasons. From 68 patients, hemodynamically significant cardiac arrythmias were detected in 18 patients(26.5%). Initial mean arterial pressure, maximal heart rate, and initial pH were identified as risk factors for hemodynamically significant cardiac arrythmias. Additionally, the patients with pressure-controlled ventilation as an initial ventilatory mode developed hemodynamically significant cardiac arrythmias less frequently than the patients with other modes(15.8% vs. 40%, p=0.03). In multivariate analysis, initial mean arterial pressure(<70mmHg, odds ratio[OR]:5.5;95% confidence interval[CI]:1.2 to 24.2, p=0.026), maximal heart rate(>120/min, OR:19.7;95% CI:2.0 to 190.0, p=0.01), and pressure-controlled ventilation(OR:0.13,95% CI:0.03 to 0.55, p=0.006) were associated with the development of hemodynamically significant cardiac arrhythmias. CONCLUSION: Theses findings suggest that during the early stages of mechanical ventilation with acute respiratory failure, hemodynamically significant cardiac arrhythmias are directly associated with tachycardia(>120/min), initial MAP(<70mmHg), and, inversely, the initial use of pressure-controlled ventilation.
Arrhythmias, Cardiac* ; Arterial Pressure ; Heart ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Multivariate Analysis ; Respiration, Artificial* ; Respiratory Insufficiency* ; Risk Factors* ; Ventilation ; Ventilators, Mechanical

BACKGROUND: Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. METHODS: The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. RESULTS: The PEFR measured with MPFM was significantly related to the PEFR and FEV1 measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r=0.92 p<0.001; for FEV1, r=0.78 ; p<0.001). The accuracy of MPFM was within 10%(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being I 6.5L/min(percentage of difference being 2.90%) or 1 0.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or -20.49~ + 9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p>0.05) and the coefficient of variation(2.4 1.2%) of PEFR measured with MPFM was significantly lower than that( 5.2 3.5%) with standard pneurnotachygraph in normal (p<0.05). CONCLUSION: This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.
Asthma ; Diagnosis ; Flowmeters ; Peak Expiratory Flow Rate ; Respiratory Function Tests

PURPOSE: In vitro interferon-gamma assays have emerged as alternatives to the tuberculin skin test for the diagnosis of latent tuberculosis infection. These assays have been performed on adults, especially in foreign countries. The aim of this study was to investigate the usefulness of interferon-gamma assays in children. METHODS: Between July 2007 and May 2009, we recruited 82 children with suspected latent tuberculosis infections. We performed chest radiography, the tuberculin skin test (2 TU) and the QuantiFERON-TB Gold assay. The volunteers who were positive for the QuantiFERON-TB Gold assay treated for 6 months with isoniazid. After treatment, the QuantiFERON-TB Gold assay was repeatedly performed. RESULTS: Of the 82 participants, 27 had positive QuantiFERON-TB Gold assay results. For the tuberculin skin test, 26 participants were positive at a 10-mm cutoff. With a cutoff point of 15 mm, 14 participants had positive tuberculin skin test results. Data on agreement between the tuberculin skin test and the QuantiFERON-TB Gold assay were available for all children. With a cutoff point of 10 mm, agreement was 86.8%, whereas with a cutoff point of 15 mm, it was 74.4%. The QuantiFERON-TB Gold assay was repeatedly performed on 7 participants, 3 of whom had persistently positive QuantiFERON-TB Gold assay results. CONCLUSION: In our study, it is suggested that the QuantiFERON-TB Gold assay may have good agreement with the tuberculin skin test. Further studies with a larger sample size are needed to evaluate a definitive relationship between the QuantiFERON-TB Gold assay and the tuberculin skin test in children
Adult ; Child ; Humans ; Interferon-gamma ; Isoniazid ; Latent Tuberculosis ; Sample Size ; Skin ; Skin Tests ; Thorax ; Tuberculin ; Tuberculosis

Lymphomatoid papulosis (LyP), first described by Macaulay in 1968, is a paradoxical skin disease characterized by a generally clinical benign course, in contrast to malignant histological features. LyP is rarely seen in children. We herein report a case of LyP in a 10-year-old boy who had a 4-week history of multiple, scattered erythematous papules, crusted papules or ulcerated papules on the trunk, arms and thighs. Histopathologically, there was a superficial and midderma1 perivascular and interstitia1 infiltrate composed primarily of lymphocytes, which were admixed with large, atypical, mononuclear cells with pleomorphic nucleus. These atypical cells expressed CD30 (Ki-1) antigen. This is the first reported case in Korea of LyP present in a child.
Arm ; Child* ; Humans ; Korea ; Lymphocytes ; Lymphomatoid Papulosis* ; Male* ; Skin Diseases ; Thigh ; Ulcer

BACKGROUND/OBJECTIVES: Eating-out among Korean people has become an important part of modern lifestyle due to tremendous growth of the food service industry and various social and economic changes. This study examined trends in meal patterns and meal sources while eating-out among Korean adults aged 19 years and older. SUBJECTS/METHODS: Data were from the 1998-2012 KNHNES (Korea National Health and Nutrition Examination Survey) by the 24-hour dietary recall method. This study included 55,718 adults aged 19 years and older. For analysis of eating-out frequency, data were categorized by source of meals and serving place. RESULTS: Average frequency of meals consumed away from home increased from 1998 to 2012, although it remained lower than that of meals at home. In addition, male, unmarried, employed, higher educated, and high income individuals more frequently consumed meals away from home. Moreover, sodium intake while eating-out significantly increased from 2,370 mg in 1998 to 2,935 mg in 2012. Lastly, percentage contributions of daily total protein intake, fat intake, and sodium intake from eating-out increased to more than half (53-55%) in 2012 compared with 47-48% in 1998. CONCLUSIONS: As eating-out has grown in popularity, greater recognition of public health and nutritional education aimed at promoting healthy food choices is needed. In addition to developing consumer education for overall healthier eating patterns, individuals who are younger, unmarried, higher educated, and males are especially at risk and require attention.
Adult* ; Eating ; Education ; Food Services ; Humans ; Korea ; Life Style ; Male ; Meals ; Nutrition Surveys* ; Public Health ; Single Person ; Sodium

No abstract available.
Teratoma*

Human Papillomaviruses(HPVs) are regarded as sexually transmitable and closely associated with precancerous lesions or invasive cancers of the vulva, vagina, and cer V1X. In situ hybridization, besides showing higher sensitivity, allowed the identification of specific viral types. We studied 12 cases of condylomata accuminata for HPV typing by in situ hybridization techenique. Ten cases(83.3 % ) showed positive for HPV type 6/11, and 2 cases(16.7% ) were positive for HPV type 16/18.
DNA Probes* ; DNA* ; Humans* ; In Situ Hybridization* ; Vagina ; Vulva

Scleroderma is a connective tissue disease characterized by excessive accumulation of collagen in skin and visceral organs due to increased collagen production by scleroderma fibroblasts. The basic etiology of this collagen accumulation is not known. We examined the expression of various extracellular matrix genes in cultured fibrolasts using Northern blot and slot-blot hybridization. The scleroderma fibroblasts exhibited characteristic mRNA size of extracellular matrix genes and prominanty increased type I and III procollagen mRNAs levels compared to control fibroblasts cultures from univolved skin. The ratios of type I /IE procollagen in scleroderma cell lines were not so much different to the controls. These results indicate that increases of collagen biosynthesis in scleroderma can be a accounted for, at least in part, by an increased content of transcriptable type I and type JE procollagen mRNAs, both.
Blotting, Northern ; Cell Line ; Collagen ; Connective Tissue Diseases ; Extracellular Matrix ; Fibroblasts* ; Procollagen ; RNA, Messenger ; Skin